Canis ISSN: 2398-2942

Fracture fixation: calcaneus

Contributor(s): Prof Mark Rochat

Introduction

  • Calcaneal fractures are uncommon.
  • Usually result from extreme flexion of the hock or a direct blow to the region. The most difficult aspect of repair is effective countering of the distractive forces of the common calcaneal tendon Calcaneal fracture fixation 01: distraction view lateral.

Uses

  • Bone plates or pin and tension band fixation are generally preferred.
  • Use pin and tension band technique for linear transverse or short oblique fractures without comminution.
  • Use lag screws also for linear oblique fractures.

Advantages

  • Plate and screws fixation - very strong method capable of resisting all types of forces acting on the fracture.
    Treatment of choice for comminuted fractures.
  • Pin and tension band technique is:
    • Inexpensive.
    • Applied with little equipment.
    • Works well for intrinsically stable fractures.

Disadvantages

  • Plate and screw fixation requires specialized equipment and training for application.
  • Lag screws are relatively weak when countering the bending forces placed on them by the calcaneal tendon.
  • Adjunctive external coaptation in the form of casting is required Calcaneal fracture fixation 02: lateral postop lag screw and cast.
    Restriction of hock range of motion after surgery is a significant limitation of this technique.

Requirements

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Preparation

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Procedure

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Aftercare

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prognosis

  • Generally, excellent for closed fractures that are adequately stabilized.
  • The prognosis for open fractures depends on:
    • Extent of infection, soft tissue and vascular insult, and adequacy of the stabilization technique.
  • Calcaneal fractures tend to heal slowly because of the strain on the fracture and the dense, relatively vessel poor bone.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Fettig A A, McCarthy R J & Kowaleski M P (2002) Intertarsal and tarsometatarsal arthrodesis using 2.0/2.7-mm or 2.7/3.5-mm hybrid dynamic compression plates. J Am Anim Hosp Assoc 38 (4), 364-369 PubMed.
  • Ost P C, Dee J F, Dee L G et al (1987) Fractures of the calcaneus in racing Greyhounds. Vet Surg 16 (1), 53-59 PubMed.

Other sources of information

  • Welch J A (2003)The tarsus and metatarsus.In:Textbook of Small Animal Surgery.3rd edn, Slatter D (ed).WB Saunders, Philadelphia, pp 2158-2169.
  • Johnson A L, Hulse D A (2002)Carpal and tarsal fractures.In:Small Animal Surgery.Fossum TW (ed). 2nd ed., Mosby St. Louis Missouri, pp 963-965.
  • Piermattei D L & Flo G L (1997)Handbook of Small Animal Orthopedics and Fracture Repair. 3rd edn. WB Saunders, Philadelphia, pp 615-618.

 


ADDED